Insert Facility Name Or a Header

NEUTRAL ZONE

[Insert facility name or a header]

ADMINISTRATIVE APPROVAL

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Purpose

To provide guidance to perioperative personnel for identifying potential sharps hazards and developing and implementing best practices, including use of a neutral zone during operative and other invasive procedures, to prevent sharps injuries and reduce bloodborne pathogen exposure to perioperative patients and personnel. The expected outcome is that personnel are free from signs and symptoms of injury caused by extraneous objects.

Policy

It is the policy of [insert name of facility] that:

· Surgical team members will use a neutral zone or hands-free technique for passing sharp instruments, blades, and needles.

· A modified neutral zone (eg, a limited hands-free passing technique) will be used during operative or other invasive procedures that require the use of a microscope.

Procedure Interventions

· Use of a neutral zone during operative or other invasive procedures will include:

o identifying the neutral zone in the preoperative briefing;

o using a basin, instrument mat, magnetic pad, or designated area on the Mayo stand as the neutral zone;

o giving verbal notification when a sharp is in the neutral zone;

o placing one sharp at a time in the neutral zone;

o orienting the sharp for easy retrieval by the surgeon;

o handling of a sharp item by only one team member at a time; and

o placing sharp items in the neutral zone after use.

· Use of a modified neutral zone during operative or other invasive procedures will include:

o the scrub person placing the sharp into the surgeon’s hand and

o the surgeon returning the sharp to the designated neutral zone.

Competency

Perioperative personnel assisting with or performing operative or other invasive procedures will receive initial and ongoing education and complete competency verification activities on the principles and processes for neutral zones and modified neutral zones.

Quality

Perioperative personnel assisting with or performing operative or other invasive procedures will participate in quality assurance and performance improvement activities related to neutral zones and modified neutral zones.

Glossary

Hands-free technique: A work practice that restricts members of the perioperative team at the sterile field from touching the same sharp instrument at the same time. Synonymous with “neutral zone.”

Neutral zone: A safe work-practice control technique used to ensure that the surgeon and scrubbed person do not touch the same sharp instrument at the same time. This technique is accomplished by establishing a designated neutral zone on the sterile field and placing sharp items within the zone for transfer of the item between scrubbed personnel. Synonymous with “hands-free technique.”

References

Guideline for sharps safety. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

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